Individual
MRS. AUDREY RAQUEL NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
901 HEMPHILL ST, FORT WORTH, TX 76104-3111
(817) 332-4060
(817) 332-2304
Mailing address
P.O. BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 378-3699
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10397
TX
Other
Enumeration date
01/25/2007
Last updated
06/10/2016
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